| Geriatric And Primary Care Services S C | |
|
1606 Castleberry Dr Marion IL 62959-1586 | |
| (618) 997-9519 | |
| (618) 993-0592 |
| Full Name | Geriatric And Primary Care Services S C |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 1606 Castleberry Dr, Marion, Illinois |
| Authorized Official Name and Position | Gladstone A Tucker (OWNER) |
| Authorized Official Contact | 6185426152 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Geriatric And Primary Care Services S C Po Box 752 Concordia MO 64020-0752 Ph: (660) 463-1365 | Geriatric And Primary Care Services S C 1606 Castleberry Dr Marion IL 62959-1586 Ph: (618) 997-9519 |
| NPI Number | 1174535900 |
|---|---|
| Provider Enumeration Date | 08/12/2006 |
| Last Update Date | 07/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174535900 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 036111926 (Illinois) | Primary |
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